Carl Siegmund Franz Credé Biography (1819-1892)

Nationality

German

Gender

Male

Occupation

Obstetrician

Credé saved the eyesight of countless newborns by discovering that a common cause of infant blindness could be prevented by applying silver nitrateeyedrops at birth. He also implemented what was known as "Credé's method" for hastening delivery of the placenta (afterbirth) during the third stage of labor, which is still used in modern obstetrical practice.

Born in Berlin in 1819, where his father was a high-ranking education official, Credé obtained most of his medical training there. He graduated from the University of Berlin in 1842 and spent the next five years studying inand traveling throughout France, Belgium, Italy, and Austria.

Returning to Berlin, Credé then served as obstetrical assistant at a local clinic. He later was recognized as a teacher of obstetrics in 1850. Twoyears later he became director of the Berlin School of Midwives and physician-in-chief at the lying-in division at Berlin's Charité Hospital.

There, Credé established one of Europe's first outpatient gynecology departments. When he was later appointed professor of obstetrics and directorof the Lying-In Hospital in Leipzig, Germany, he established a similar department there in Leipzig.

Credé's method of hastening delivery of the placenta was by no means new. The practice, involving massage applied to the abdomen externally, was previously known to Hippocrates, the people of Old Calabar in southeastern Nigeria, and to numerous aboriginal tribes in North America. Credé credited an Austrian doctor named von Plenck with developing the technique.

But Credé popularized the idea after he became concerned with the standard practice of rushing removal of the placenta by pulling on the umbilicalcord and manually invading the vagina and uterus, which increased the risks of bleeding, infection, and inversion of the uterus. He taught his obstetricsstudents that the less a woman is handled, the lower the risk of infection. For this reason, Credé vigorously opposed the tendency of nineteenth-century doctors and midwives to conduct internal examinations of women in labor.

Massage, applied externally, was nonetheless acceptable to quicken the thirdstage of labor, to lessen the anxiety of the mother and "to allow the physician to return to his other responsibilities," Credé wrote. His method is still used by doctors and midwives when the mother is unable to push out the placenta herself.

Credé's greatest legacy was his use of silver nitrate to prevent ophthalmia neonatorum, a potentially blinding disease that occurred in as many as12% of live births. Of those, 3% of infants were blinded and 20% had at leastsome degree of eye damage. The disease was acquired by the newborns as theypassed through an infected birth canal, most commonly when the mother had gonorrhea.

Washing an infant's eyes to prevent infection had been tried with various substances including water, chlorine water, and solutions of thymol, carbolic acid, salicylic acid, and potassium permanganate. Silver nitrate had also beenpreviously tried, but Credé refined the technique (a single drop of 2%silver nitrate solution applied with a glass rod) and demonstrated its effectiveness. In a three-year period in the early 1880s, among 1,160 newborns treated by Credé with silver nitrate, only two developed ophthalmia. Thiscompares with 111 infants who developed the disease among 977 untreated births at the same hospital from 1874-1876.

Credé's silver nitrate treatment (the solution was later diluted to 1%) became widely accepted as standard obstetrical practice. It continues to beused in some jurisdictions, although gonorrhea is not as common among mothers and silver nitrate is now frequently replaced by eye drops that are less irritating.

Credé was also a prominent writer, editor, teacher, and administrator.His Clinical Lectures on Midwifery, coauthored with son-in-law Gerhard Leopold and published in 1853 and 1854, went through five editions and later was translated into English. He wrote other textbooks and edited a prominent German gynecological journal for almost 40 years.

Due to prostate cancer, Credé was forced to retire in 1887, dying fiveyears later. Sadly, the man who prevented so many cases of blindness was himself rendered sightless in his final months of life by kidney failure.

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